Holly Ford, Health System writer, contributed this post. Holly writes about her own 9-year-old daughter’s struggle with anorexia in UVA’s family health magazine Vim & Vigor.
With a big push from the White House, the U.S. has undertaken a crusade to end 
childhood obesity. Many states, including Virginia, have adopted the FitnessGram Program, which incorporates body composition screenings and fitness assessments into schools’ health curriculum and stresses to kids the importance of daily exercise and a healthy diet. The impact has been significant – and commendable.
However, in our quest to tackle obesity, we have to be sure not to overlook the flip side. Because there is such a thing as being too thin and too food-obsessed. But do we really know what that looks like? Can we spot those children who may be struggling with disordered eating (extreme and inconsistent eating patterns) or a more serious eating disorder (anorexia, bulimia, binge-eating disorder)? To do so, we have to peel back the misconceptions and let go of the stereotypes. Here are a few for parents to consider.
Myth #1: Eating Disorders Are a Girl Problem
Think boys are immune from weight worries? Think again. “Eating disorders are becoming more common among boys,” says Ashleigh Sellman, a registered dietitian for the Nutrition Counseling Center.
“One thing we are seeing is the athlete who feels pressure to be a certain way, so they have that perfectionist ideal and obsession with being healthy.”
According to the National Eating Disorders Association (NEDA), 30 percent of teenage boys use unhealthy weight control behaviors such as skipping meals, fasting, vomiting and laxatives to control their weight. While they are still more common in females, NEDA reports that 10 million men in the U.S. have an eating disorder at some point in their lives.
Myth #2: Until She’s a Teen, I Don’t Have to Worry
Eating disorders can strike at any age, says Sellman. In fact, more and more younger children are being diagnosed – some as young as nine. In one survey, the NEDA found that 42 percent of first and third graders want to be thinner. Some of them will act on those desires, adopting behaviors that lead to eating disorders.
While Sellman stresses that no one thing can cause an eating disorder, children today are exposed to certain triggers that, for some, can be the turning point: They are bombarded with images of an unrealistic body type and are getting messages about the importance of being health-conscious at every turn. “We are so food-, weight- and body-obsessed as a country that things are more complicated for kids today,” she says.
Myth #3: Normal Weight … No Problem
Although some exhibit the bony frame and emaciated features we commonly associate with an eating disorder, the physical signs aren’t always apparent. Those who suffer from bulimia and binge eating may range from normal to overweight, says Sellman. Even those with anorexia, which is synonymous with skinny for many of us, can be obese. It is the behavior – restrictive eating, extreme weight loss, purging – that leads to an eating disorder diagnosis, not just pounds alone.
Myth #4: You Can’t Be Too Health Conscious
Most of us try to encourage healthy behaviors in our kids, so when we see them reaching for the apple instead of the Chips Ahoy, we pat ourselves on the back. But when kids begin setting hard rules for themselves regarding diet (i.e. no carbohydrates, no more than 1200 calories a day or no eating after 6 p.m.), it may be a sign that they’re taking things too far.
The same goes with exercise. Being active instead of sitting in front of a TV for hours is obviously preferable, but if a child begins working out excessively or keeping a close watch on how many calories she’s burning, her increased activity level may be cause for concern.
Eating Disorders: Prevent by Paying Attention
Eating disorders come in all shapes and sizes and can impact anyone at any age. So just because your child doesn’t portray the stereotypical traits of someone with an eating disorder doesn’t mean you shouldn’t be on the lookout for warning signs. Be aware of what your kids are eating, how they feel about food and their bodies. And when you talk to them about being healthy, be sure to cover all the bases, emphasizing that thin and healthy aren’t necessarily one and the same.
If you have questions or concerns about your child’s health, talk to your pediatrician. For a referral to a UVA pediatrician, call 434.924.3627. Learn more about UVA pediatric services.